Welcome to a site dedicated to understanding, rather than memorising, the great subject of medicine.

Monday, 16 March 2009

What's the most sensitive test by which to grade acute liver failure?

For me, the answer would be theINR.

You see, the liver is responsible for the generation of almost all the plasma proteins, including the clotting factors. Therefore, in liver failure, the INR will be prolonged.

The other common measure of the liver's synthetic ability is albumin, but this changes too slowly for it to be much use in acute liver failure.

The transaminases (AST, ALT) also come to mind, although on closer inspection they appear to be less useful. For their levels to be elevated, enough of the enzymes must be released into the bloodstream as the liver gets damaged. For this reason, falling transaminases may simply mean that so much of the liver has been destroyed that there isn't much AST or ALT left!

Of course, measuring the INR also reminds you about one of the major complications of acute liver failure: haemorrhage.

About me...

Hit Counter

... since October 2008

Disclaimer

This is a site dedicated to interesting and sometimes complicated ideas - in the abstract. This is NOT a site from which to obtain medical advice for yourself, your family or your friends. When it comes to specific health problems, nothing can replace the dedicated attentions of a medical doctor.